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700 Broadway Avenue East Suite 39 Mattoon IL 61938-4662 | |
(217) 234-3091 | |
(217) 234-3094 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 700 Broadway Avenue East, Mattoon, Illinois |
Authorized Official Name and Position | Barbara B Dunn (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2178776111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2905 North Main Street Decatur IL 62526 Ph: (217) 877-9117 | 700 Broadway Avenue East Suite 39 Mattoon IL 61938-4662 Ph: (217) 234-3091 |
NPI Number | 1235455130 |
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Provider Enumeration Date | 04/16/2010 |
Last Update Date | 11/03/2011 |
Identifier | Type | State | Issuer |
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1235455130 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Bella Family Health And Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10555 E County Road 800n, Mattoon, IL 61938 Phone: 217-235-4227 Fax: 217-235-4274 | |